A Debate On Smokeless Tobacco

In a debate in this week's PLoS Medicine, public health researchers discuss whether or not the public should be informed that using oral, smokeless tobacco (Swedish snus) is less hazardous to health than smoking tobacco.

Arguing the case for providing such information, Carol Gartner and Wayne Hall (University of Queensland, Australia) point to the Swedish experience. Snus seems to be widely used as an alternative to cigarettes in Sweden, contributing to the low overall prevalence of smoking and smoking-related disease. "On the Swedish experience," say Gartner and Hall, "there is a strong prima facie case on public health and ethical grounds for recommending snus to inveterate smokers who want to reduce their health risks and for considering public policies, such as lower taxes for snus and public information campaigns, to promote its use by smokers."

However, Simon Chapman and Becky Freedman (University of Sydney, Australia) argue that Sweden's experience is likely to be specific to that culture and not transferable to other settings, and that if tobacco companies are allowed to market snus they will undoubtedly use the opportunity to promote tobacco as well. "Snus enthusiasts in the public health community," say Chapman and Freedman, "focus on snus' potential to take people away from smoking. However transnational tobacco companies are already marketing snus using slogans that mention smoking, such as: 'When you can't smoke, snus.'"

Citation: Gartner CE, Hall WD, Chapman S, Freeman B (2007) Should the health community promote smokeless tobacco (snus) as a harm reduction measure? PLoS Med 4(7): e185